Description: (from applicant's Abstract) The Incidence of chronic illness in the United States has increased dramatically during the last six decades. Chronic illnesses are permanent, leave residual disability, require long-term health care, and special adaptation on the part of the individuals and their families. Self-management of chronic conditions involves controlling symptoms and adapting to physical, psychological, and social changes. Uncertainty has been identified as a constant accompaniment of chronic illness that can negatively influence individual's adaptive behaviors and psycho-social outcomes. One-fourth of America's population live in rural areas, and compared with urban Americans, rural dwellers tend to be in poorer health, and have fewer health care resources. "Exploring Chronic Illness in Isolated Rural Women" is a qualitative study designed to explore and describe the illness uncertainty and illness management experiences of chronically ill middle-aged women living in isolated rural areas. Specific aims are to: (a) identify common themes related to illness uncertainty and chronic illness management; (b) explore the relationship of demographic factors, length of illness, health status, degree of ruralness, psychological adjustment, and social support to uncertainty and illness management; and (c) compare findings with previously completed research that explored chronic illness uncertainty in urban residents. The aims will be achieved through secondary analysis of existing data taken from a large intervention study that used telecommunications technology to provide information and mutual support to isolated middle-aged rural women with rheumatoid conditions, cancer, diabetes, and multiple scleroses. Chat room conversations will be analyzed for common themes using content analysis methods. Demographic and health status information, and scores from social support and psychological adjustment measures will be analyzed to provide a better understanding of the illness uncertainty and illness management experiences. A better understanding of the challenges facing isolated rural women is essential to nurses' ability to formulate effective interventions that support self-management, adjustment, and adaptation to chronic illness. A second goal of this study is capacity building of a novice scientist through collaboration with more senior scientists associated with the Center. The expected outcomes are the: (a) enhancement of skills related to secondary data analysis (including refined skills with SPSS and QRS NUD*IST), (b) management of large data sets, and (c) strengthening of skills associated with active participation on a research team. The outcomes of this study will provide direction for planned future work to develop and test chronic illness management strategies for use by rural dwellers.